Overview of CPT Code 19371: Breast Reconstruction with Tissue Expander
CPT Code 19371 refers to the surgical procedure of breast reconstruction using a tissue expander, typically performed after mastectomy to restore breast shape and volume.
When CPT Code 19371 is Used?
This procedure is indicated in various clinical scenarios.
- Post-mastectomy breast reconstruction for patients with breast cancer.
- Reconstruction after lumpectomy when significant tissue loss occurs.
- Patients seeking to restore breast symmetry after unilateral mastectomy.
Symptoms Indicating This Procedure
Patients may present with specific symptoms that warrant this procedure.
- Loss of breast tissue due to mastectomy.
- Desire for breast reconstruction for aesthetic reasons.
- Physical discomfort or psychological distress related to breast loss.
Causes and Risk Factors
Several factors can lead to the need for this procedure.
- Breast cancer requiring mastectomy.
- Genetic predisposition to breast cancer (e.g., BRCA mutations).
- Previous breast surgeries that resulted in tissue loss.
Diagnostic Tests Before Procedure
Certain tests are essential to evaluate the patient's condition prior to surgery.
- Mammography to assess breast tissue.
- MRI for detailed imaging of breast anatomy.
- Biopsy to confirm the diagnosis of breast cancer.
Procedure Description
The procedure involves several key steps.
- Anesthesia is administered to ensure patient comfort.
- Incisions are made to create a pocket for the tissue expander.
- The tissue expander is inserted and positioned under the chest muscle.
- The expander is gradually filled with saline over time to stretch the skin.
- Follow-up appointments are scheduled to monitor the expansion process.
Preparation for the Procedure
Patients should follow specific guidelines before surgery.
- Consult with the surgeon to discuss expectations and risks.
- Avoid blood thinners and certain medications as advised.
- Arrange for post-operative transportation and support.
Recovery and Aftercare
Post-operative care is crucial for healing.
- Expected recovery period is typically 4 to 6 weeks.
- Wound care instructions should be followed to prevent infection.
- Pain management may include prescribed medications and over-the-counter pain relievers.
Possible Complications
As with any surgery, there are potential risks involved.
- Infection at the surgical site.
- Bleeding or hematoma formation.
- Complications related to the tissue expander, such as rupture or displacement.
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Post-Procedure Follow-Up
Regular follow-up is essential for monitoring recovery.
- Initial follow-up within 1 to 2 weeks post-surgery.
- Subsequent visits every few weeks to assess the expansion process.
- Long-term follow-up to evaluate the final reconstruction outcome.
Alternative Treatments
There are non-surgical options available for breast reconstruction.
- Prosthetic breast forms for external use.
- Fat grafting techniques to enhance breast volume.
- Psychological counseling for emotional support.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Keep the surgical area clean and dry.
- Wear a supportive bra as recommended by the surgeon.
- Engage in light activities as tolerated, avoiding heavy lifting.
Patient Education & Prevention
Education is key to preventing complications and recurrence.
- Understand the importance of regular breast screenings.
- Discuss genetic testing options if there is a family history of breast cancer.
- Maintain a healthy lifestyle to reduce cancer risk.
Billing and Coding Information
CPT Code: 19371
Category: Surgery
Common Modifiers:
- -50 Bilateral procedure
- -RT Right side
- -LT Left side
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $10,000 to $30,000.
- Insurance may cover the procedure if deemed medically necessary.
- Patients should verify coverage details with their insurance provider.
Related CPT Codes
- 19368 - Breast Reconstruction with Tissue Expander
- 19369 - Breast Reconstruction with Implant
- 19370 - Breast Reconstruction with Tissue Expander
References and Sources
Frequently Asked Questions (FAQs)
What is a tissue expander?
A tissue expander is a device used to stretch the skin and create space for a permanent implant.
How long does the procedure take?
The procedure typically takes 1 to 3 hours, depending on individual circumstances.
Will I have scars after the surgery?
Yes, there will be scars, but they usually fade over time.
How soon can I return to normal activities?
Most patients can resume light activities within a few weeks, but full recovery may take longer.
